Delirium is a serious disturbance in cerebral abilities that results in confused thinking g and reduced awareness of your local environment. The star of delirium is normally rapid, occurring within an hour or a few days.
Delirium can often be traced to one or more contributing factors, such as severe or chronic medical illness, differences in your metabolic balance ( such as low sodium), 感染, 药物治疗, surgery, or alcohol or drug withdrawal.
Because symptoms of delirium and 痴呆 can be comparable, input from a family member or caregiver may be essential for a physician to make an accurate diagnosis.
Symptoms of Delirium
Signs and symptoms of Delirium usually begin over a few or a few days. They often fluctuate thought the day. There could be periods where no symptoms are shown. Symptoms tend to be worst during the night when it’s dark, and things look less familiar.
Main signs and symptoms include:
Reduce awareness of the environment
This may result in:
- An inability to remain focused on a topic or to witch topics
- Getting stuck on an idea rather than responding to questions or conversation
- Being simply distracted by irrelevant things.
- Being withdrawn, with little or no activity or little reply to the environment.
Poor/Impaired Cognitive (Thinking) Skills
This may appear as:
- Poor memory, particular or recent events
- DIroientation, 例如, not knowing where you are or who you are
- Difficulty speaking or recalling words
- Troblue understanding speech
- Difficulty reading or writing
- Rambling or nonsensical speech
This may include:
- Seeing thing that does not exist (幻觉)
- Restlessness, agitation or combative behavior
- Disturbed sleep habits
- Reveal or night -day sleep wake cycle
- Calling out, moaning or making other sounds
- Being quiet and withdrawn – specifically in older adults
- Lethargy slowed movement
This may appear as:
- 焦虑, 恐惧或偏执
- 感觉感扬眉吐气 (欣快症)
- Personality changes
- 多动谵妄 – 也许最明显的形式，认识到这一点可能包括躁动 ( 运动, 起搏) 快速的情绪变化, 搅拌或幻觉.
- 机能减退的谵妄 - 这可以包括无活性或减少的运动活动迟缓, 异常嗜睡或似乎在发呆.
- Mixed delirium This comprises both hyperactive and hypoactive symptoms. The person may suddenly shift back and forth from hyperactive to hypoactive states.
Delirium and dementia
- Dementia and delirium may be especially challenging to distinguish, and a person may have both. Fewuqily delirium occurs in those who have dementia,
- Dementia is a progressive decline of memory and cognitive skills due to the gradual degradation and loss of brain cells. The most frequent cause of dementia is Alzheimer’s diseases.
- Some difference between the symptom of delirium and dementia include:
One set of delirium transpires within a short time, while dementia usually starts with comparatively minor symptoms that gradually worsen over time.
Attention, The capability to stay focused or sustain attention is dramatically impaired with delirium. A person with the early stages of dementia will remain alert.
- Fluctuation. The presence of delirium symptoms can fluctuate significantly and frequently through the day. Whi;e people with dementia have better and worse times of the day. Thier memory and thinking skills stay a fairly consistent level during a day.
If a relative, friend or someone you care shows any signs of symptoms of delirium, see a physician, Your input about the person’s symptoms, 以及他或典型的思想和日常生活能力, 将是至关重要的一个适当的诊断和用餐的根本原因.
如果您发现在医院或护理院的标志和精神错乱的症状的个体, 报告您关心的护理人员或医生，而不是假设这些问题已经观察. 老年人在医院休养或生活在长期护理设施尤其在精神错乱的风险.
谵妄可以有一个单一的原因或多个原因, 诸如医疗条件和医疗毒性. Sometimes there are no circumstances identified
Possible causes include:
- Alcohol or drug abuse or withdrawal
- A medical condition
- Certain medications or drug toxicity
- Metabolic imbalance, Such as low sodium and low calcium
- Severe, chronic or terminal illness
- Fever and acute infection, particularly in children.
- Surgery or other medical procedures that incorporate anesthesia
- Sleep deprivation or severe emotional distress
Several medications or combinations of drugs can trigger delirium, including some type of:
- Allergy medications (antihistamines)
- Parkinson’s disease drugs
- Asthma medications
- Drugs for treating spasm and convulsions
- Sleep medications
- Medications for mood disorders, such anxiety, 和抑郁症
- Parkison diseases
Any condition that ends in a hospital stay, especially in intensive care or after surgery, increase the risk of delirium, as does being a resident in a nursing residence.
An example of other conditions that increase the risk of delirium include:
- Oder Age
- Visual or hearing impairment
- Having multiple medical problems
- Brain disorders such as dementia, stroke or Pakrisions’ disease
Delirium may last only a few hours or as long as several weeks or months. If issues that produce delirium symptoms are addressed, the recovery is often shorter.
The degree of recovery depends to some extent on the health and mental status before the onset of delirium. For example, individuals with dementia experience a significant overall decline in thinking skills and memory. People in better health are more likely to recover.
People . with other serious, chronic or terminal ailments may not regain the levels of thinking skills or function that they had before the state of delirium. Delirium is serious people is more likely to lead to:
- Poor recovery from surgery
- Need for institutional care
- Increase risk of death, specifically with hypoactive delirium
- The general decline in health.
Test and diagnosis of Delirium:
A physician will diagnose delirium based on medical history, test s to assess mental status and the identification or possible contributing factors An examination may include:
Mental status assessment A physician starts by evaluating awareness, 思维, and attention. This may be accomplished informally through conversation, or with test or screening that assess the mental state, 混乱, 知觉, and memory.
Physical and neurological exam. The physician conducts a physical exam, checking for signs of health problems or underlying disease. 神经学检查 – 视力检查, 平衡, 协调, 和反射-CAñ帮助确定中风和其他神经系统疾病是导致精神错乱.
另一种可能的测试- 医生可以命令血液, 尿, 和另一诊断测试. 当一个诊断可以与其它可用的信息来进行，可以使用的大脑成像测试.
治疗谵妄的第一个目的是要解决任何潜在的原因或触发器 – 例如, 通过停止使用特定药物的或治疗感染.
Treatment then focuses on creating the best environment for healing the body and calming the brain.
- Supportive care
- Supportive care aims to prevent complications by:
其他类型的药物可能有助于平息一个人谁不认识环境在某种程度上导致严重的妄想症, 幻觉或恐惧, 和混乱或严重躁动.
- Prevent the predominance of medical examination or treatment
- Endangerethe person of threatens the safety and well being or other people
- These medications are normally reduced in dose or discontinued when the delirium is resolved
The most encouraging approach to stopping delirium is to focus on risk factors that might cause episodes. Hospital environments present special changes. Because of the invasive procedures, loud noise, frequent room changes, 光线不好和缺乏自然光可以恶化的混乱.
Evendicne表明，这些策略 – 促进良好的睡眠习惯, 帮助人保持良好取向和冷静, 并有助于防止其他医疗问题可以防止或减少谵妄的严重程度.